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National Space Conference, Pakistan
National Space Conference, Pakistan
National Space Conference Role of WHO in promoting space
technology for health:
tele-health initiatives around the world
17- 19 September 2012
Islamabad, Pakistan
Najeeb Al-Shorbaji, Director Knowledge Management and Sharing
World Health Organization
National Space Conference, Pakistan | 25 September 2012 3 |
eHealth tools an services
Technicians erecting
VSAT dishes in
Islamabad,
Pakistan, to provide
the vital satellite
health
communications
links required
between WHO
headquarters and
the field.
National Space Conference, Pakistan | 25 September 2012 4 |
eHealth tools an services
WHO emergency response team member collecting surveillance data and transmitting it to WHO/HQ after the devastating earthquake in Pakistan in October 2005.
National Space Conference, Pakistan | 25 September 2012 5 |
The context: WHA Resolutions 58.28 on
eHealth
eHealth as the cost-effective and secure use of
information and communication technologies in
support of health and health-related fields, including
health-care services, health surveillance, health
literature, and health education.
The resolution requested the Director-General of
WHO, among other things, to promote international,
multisectoral collaboration, to provide technical
support to Member States, to facilitate the integration
of eHealth in health systems.
National Space Conference, Pakistan | 25 September 2012 6 |
eHealth resolution: Countries
Draw up plans for eHealth services
Develop ICT infrastructure
Closer collaboration with private and non-profit
sectors in ICT
Reach communities, including vulnerable
groups, with eHealth services appropriate to
needs
National Space Conference, Pakistan | 25 September 2012 7 |
e-Learning e-Care
Scope of eHealth applications and
services
e-Surveillance
e-Management
eHealth
Governance
National Space Conference, Pakistan | 25 September 2012 8 |
Satellite potential benefits to public health
Final report of the Action Team on Public Health:
the use of space technology to improve public
health of the Committee on the Peaceful Uses of
Outer Space Scientific and Technical
Subcommittee Forty-eighth session, Vienna, 7-
18 February 2011,
Satellite communication,
Global positioning systems and
Remote sensing space technologies.
National Space Conference, Pakistan | 25 September 2012 9 |
Satellite utilization by WHO
Public health mapping
Disease surveillance (eSurveillance)
Epidemiology (eEpidemiology or Tele-Epidemiology)
Water supply and delivery
Poverty mapping
Emergency and disasters
Data and voice communication
Enabling access to health information and learning materials
Partnerships and technical advice
National Space Conference, Pakistan | 25 September 2012 10 |
De-isolating care
professionals
Dr Diakaridia Traoré continued to serve
his community in Rural hospital in
Dimmbal, Mali.
800 km away from the capital.
120 km away from the first Internet access.
20 km away from telephone access.
National Space Conference, Pakistan | 25 September 2012 11 |
HINARI reaches the most remote areas
through a satellite connection
Three other factors helped significantly in making
this a successful workshop. The Internet access
probably was the best from all the workshops I
have conducted in HINARI eligible institutions
(the satellite dish was right outside the window of
the computer lab) and the IT staff were very
helpful.
http://www.mlanet.org/resources/global/lwb_elibr
arytraining_workshops.html
National Space Conference, Pakistan | 25 September 2012 12 |
IHR implementation requires stable
connectivity
Under the International Health
Regulations, (IHR), WHO has a
commitment to countries to have a team
on the ground within 24 hours and they
need to be able to hit the ground running.
Critical to disease outbreak response is
having teams in the field that are able to
communicate with each other as well as to
WHO country and regional offices and
headquarters. But in remote areas and
inhospitable environments, telephone
connections, data transmission and
access to the Internet are often limited and
unreliable
National Space Conference, Pakistan | 25 September 2012 13 |
Pilot in Nigeria and Pakistan demonstrated the
utility of GIS in (supplementary immunization activity/activities) SIA
operation
• Identify the missed area during implementation
–Visualize the geographic gap of team's activity
–Enables effective supervision and revisits
•Digitize team's movement
–Specify "ideal" movement of each day
–Reduce risk of missing areas and enable better supervision
•Digitize Union Council (UC), area and team boundaries
–Clarify the exact team/area responsibilities
– Identify gaps and ensure all areas are accounted for
National Space Conference, Pakistan | 25 September 2012 14 |
Overview on Quantitative Evaluation in Pakistan
Selected Four UCs in Peshawar and Karachi for Evaluation
•Two Intervention UCs (one in Peshawar and the other in Karachi)
•Two Control UCs (with similar risk profile to intervention UCs)
In Intervention UC, GIS was used to improve SIA quality
• Intervention were done during May/June SIA in Peshawar and two rounds in July SIA in Karachi
• In Peshawar, UC/Area in Charge (AIC) and all team boundaries were clarified, team movement was digitized and implementation was monitored with GPS
• In Karachi, only UC and AIC boundaries were clarified due to deteriorating security situation in the city
The change in SIA quality was monitored in all UCs
• Number of children immunized (before and after intervention)
• LQAS results
National Space Conference, Pakistan | 25 September 2012 15 |
Area-in-charge (AICs)
walked around their areas
with GPS and digitized
area/team boundaries
This exercise enabled to
clarify discrepancy between
team boundaries and UC
boundaries (yellow) as well
as unclaimed areas (purple)
Boundaries are Clarified in Tekhal Bala UC
(Peshawar)
National Space Conference, Pakistan | 25 September 2012 16 |
PICs
No one is assigned from
this UC (yellow)
No AICs assigned in some
areas (Purple)
Two AICs claims the
responsibility of the same area
Boundaries are clarified in Gaddap UC (Karachi)
National Space Conference, Pakistan | 25 September 2012 17 |
All 20 team's activities were analyzed after three days of SIA
GPS coordinates identified possible missed areas
WHO staff/AIC confirmed missing areas and send teams during revisit
Geographic gaps were identified during May
SIA (Tekhal Bala, Peshawar)
National Space Conference, Pakistan | 25 September 2012 18 |
Daily team movement was digitized (Tekhal
Bala, Peshawar)
National Space Conference, Pakistan | 25 September 2012 19 |
Overview on quantitative evaluation in Pakistan: key take away messages Use of GIS is feasible and effective in the field
This concept is easily trained and implemented locally
Use of GIS has improve the SIA coverage significantly by clarifying
responsibility and ensuring accountability.
Digitizing UC/Team/Area boundaries alone is
effective enough to improve SIAs There are many gaps and misunderstanding in many places
This is less sensitive and more acceptable to the local communities than
implementation monitoring
Local community engagement and GPS use is critical in
setting up boundaries
Local team leaders (e.g., Area in Charge, UC officers) should meet and
confirm the responsibilities after the exercise
Without GPS, drawing boundaries on the satellite image is difficult.
National Space Conference, Pakistan | 25 September 2012 20 |
Global Alert and Response
Rift Valley Fever (RVF) forecasting model in Africa and Middle East with NASA
http://www.who.int/csr/disease/riftvalleyfev/en/
CCHF (Crimean-Congo Hemorrhagic Fever) risk mapping models with Oxford University
The Meningitis Environmental Risk
Information Technologies (MERIT) project in West Africa with International Research Institute for Climate and Society (IRI)
http://merit.hc-foundation.org/aboutMERIT.html
Plague project in Kazakhstan with CNES
National Space Conference, Pakistan | 25 September 2012 21 |
21 21
*1 [Source] Eastern Mediterranean Regional Office, WHO (2001)
Setting up a satellite for voice, data and
internet
Afghanistan*1:
Setting-up of satellite and its related hardware is relatively easy since 2001.
Data transmission through satellite has been used in a sustainable manner since 2001.
In addition to fixed satellite stations in multiple location, mobile unit (RBGAN) were used and satellite phones for health professionals use.
Voice, data and internet access.
National Space Conference, Pakistan | 25 September 2012 22 |
The WHO eAtlas of disaster risk
for African Region
for European Region
for the Eastern Mediterranean Region
National Space Conference, Pakistan | 25 September 2012 23 |
International cooperation and partnerships
RAFT -
Distance Learning program webcast, and tele-
consultation forums via satellite in 18 African
countries, and expanding;
Pan Africa eNetwork;
An eNetwork covering all countries in Africa.
Funded by the Indian government, and
connecting hospitals and universities in each
African country with their counterparts in India;
National Space Conference, Pakistan | 25 September 2012 24 |
International cooperation and partnerships
ESA
An EC funded satellite-based project supporting health services in Sub Saharan Africa.
WHO served as a member of the task force (WHO, EC, AUC, ADBank, African sub-regional organizations) guiding the development of the Pan African eNetwork programs;
Possible collaboration between JAXA and WHO
Data transmission services for developing world
Provide free services of data transmission and GPI along with mapping particularly for rural/remote areas of Pacific Island countries and Sub-Saharan Africa.
A JAXA satellite may become a first WHO collaboration centre in the space!
National Space Conference, Pakistan | 25 September 2012 25 |
Challenges to wide use and scaling up of
satellite use in public health
High cost
unaffordable cost of data transmission has lead to short lived projects
Limited availability & up-datedness of GIS
despite its great demand for global health purposes, GIS in Africa is poorly available and updated, due to difficulty in commercialization
Licensing and political sensitivity
difficult to license for services and to manage
the gap between satellite data and government data.
National Space Conference, Pakistan | 25 September 2012 26 |
Challenges to wide use and scaling up of
satellite use in public health
Interoperability and standardization
has lead to fragmentation, duplication of effort and unsustainable and more costly projects.
Absence of national eHealth strategies and
plans has lead to short term un-scalable projects, lack of intersectoral collaboration and chaos.
Week infrastructure
has lead to interrupted or absent power supply, shortage of skilled human resources, lack of coordination between different government agencies.
National Space Conference, Pakistan | 25 September 2012 27 |
Recommendations for implementation of
space technology in public health in Pakistan
Development of public-private partnerships between UN agencies, the government, national space agency and commercial satellite companies aiming to provide free transponder space on commercial satellites with small aperture antenna in different provinces in Pakistan;
Urging federal ministries of telecommunications and telecommunication regulatory authorities to facilitate licensing of satellite services to support the humanitarian use of satellite such health services, disaster management, eLearning and epidemiological surveillance, especially in remote areas of Pakistan.
National Space Conference, Pakistan | 25 September 2012 28 |
Recommendations for implementation of
space technology in public health in Pakistan
Establishment of collaborative programmes at the national level (Space agency, finance, health and telecommunication authorities) to:
Develop integrated national systems for the management of health data and link the systems to digital maps for use by technical programmes,
Build, develop and maintain a comprehensive collection of national and provisional digital maps including detailed administrative, health levels, water resources, transportation, hazardous areas, disaster-prone areas and health care facilities. Develop,
Support capacity building to acquire and use satellite images, converting them to digital maps and linking them to health data through integrated geographic information systems.
National Space Conference, Pakistan | 25 September 2012 29 |
(Space agency, finance, health and
telecommunication)
Collaborate with WHO to develop Pakistan national eHealth strategy, roadmap and plans through:
Strengthening human and institutional capacity at the government level to conduct national eHealth planning.
Ensuring high-level political commitment to lead the process.
Providing technical expertise during the planning process in specific areas identified and requested by implementing agency.
Facilitating knowledge sharing at country levels and link at regional and global level.
National Space Conference, Pakistan
Thank you
Q / A
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